No office rate
Use 27447 for a primary total knee replacement. This code is for revision surgery on the knee joint.
On this page
CMS RVU26D · Effective 2026-10-01
27441 Knee revision Medicare reimbursement rates in Iowa
Reports revision surgery on the knee joint, with code selection supported by the operative report describing the specific revision performed. Compare 27441 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27441 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$693.64
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 27441: Knee joint revision
Reports revision surgery on the knee joint, with code selection supported by the operative report describing the specific revision performed.
This code represents operative revision of a knee joint. An orthopedic surgeon typically performs the procedure in an operating room when the knee requires surgical revision after prior treatment. The operative report should identify the joint work performed and explain why revision was needed; the code should not be selected from the diagnosis alone.
Report it for the documented revision service, distinguishing it from a primary total knee replacement and from revision codes with more specifically defined work. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, payment is at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 27441
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.25 · 49%
- Practice expense (office) RVU9.36 · 41%
- Malpractice RVU2.40 · 10%
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
27441 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
27486 specifically describes revision of one component of a total knee arthroplasty. Select this code when the operative work meets that component-specific description.
No office rate
27487 specifically describes revision involving the femoral and tibial components of a total knee arthroplasty. Use it when the documented work matches that scope.
Compare 27441 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$693.64
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27441 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,895
- Code
- 27441
- Physician work
- 11.25
- Practice expense
- 9.36
- Malpractice
- 2.40
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.25 | × 1.000 | 11.2500 |
| Practice expense | 9.36 | × 0.915 | 8.5644 |
| Malpractice | 2.40 | × 0.397 | 0.9528 |
| Total RVUs | 20.7672 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$693.64
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.25 | 1 |
| Practice expense | 9.36 | 0.915 |
| Malpractice | 2.4 | 0.397 |
(11.25 × 1 + 9.36 × 0.915 + 2.4 × 0.397) × $33.4009 = $693.64
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
27441 billing questions
How is this distinguished from a primary total knee replacement?
This code is for revision surgery on a knee joint. A primary total knee replacement is reported with 27447 when the documented procedure is primary rather than revision surgery.
What documentation supports reporting this code?
The operative report should describe the revision performed, the knee joint work, and the clinical reason for revising it. The diagnosis by itself does not establish the service.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is this code paid when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
Can modifier 50 be used for bilateral surgery?
Yes. CMS identifies this as a bilateral procedure; reporting modifier 50 results in payment at 150%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,89227437,,Revise kneecap,A,,8.71,8.16,NA,8.16,,1.84,18.71,18.71,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89327438,,Revise kneecap with implant,A,,11.59,9.39,NA,9.39,,2.43,23.41,23.41,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89427440,,Revision of knee joint,A,,10.81,9.21,NA,9.21,,2.31,22.33,22.33,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89527441,,Revision of knee joint,A,,11.25,9.36,NA,9.36,,2.40,23.01,23.01,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89627442,,Revision of knee joint,A,,12.06,9.51,NA,9.51,,2.53,24.10,24.10,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89727443,,Revision of knee joint,A,,11.12,9.32,NA,9.32,,2.37,22.81,22.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89827446,,Revision of knee joint,A,,16.70,11.13,NA,11.13,,3.53,31.36,31.36,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136